MEDICARE: HOMER MCCOY HARRISON JR. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA10433	CA

General Provider Information

NPI Number	:	1760523161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOMER MCCOY HARRISON JR. PA

Provider Business Mailing Address
First Line	:	2421 GRIMSBY DR
Second Line	:
City	:	ANTIOCH
State	:	CA
Zip	:	94509-5866
Country	:	US
Telephone Number	:	925-778-2358
Fax Number	:

Provider Business Practice Location Address
First Line	:	3663 ARCH RD
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95215-8315
Country	:	US
Telephone Number	:	209-943-2202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1649256934 — DR. JON L ECK MD
Practice Location Address:

3663 ARCH RD STE 400
STOCKTON, CA
95215-8315

Practice Phone: 209-943-2202
Practice Fax:

1851407654 — MS. JOSEPHINE LYNNE NANCE PT
Practice Location Address:

3663 ARCH RD , ST 400
STOCKTON, CA
95215-8315

Practice Phone: 209-943-0202
Practice Fax: 209-943-2209

1902955859 — BRADLEY DONALD TOURTLOTTE MD
Practice Location Address:

3663 ARCH RD , SUITE 400
STOCKTON, CA
95215-8315

Practice Phone: 209-943-2202
Practice Fax: 209-943-2209

1851867246 — AMERICAN CURRENT CARE OF CALIFORNIA, A MEDICAL CORPORATION
Practice Location Address:

3663 ARCH RD STE 400
STOCKTON, CA
95215-8315

Practice Phone: 209-943-2202
Practice Fax: 209-943-2209

1760958151 — OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
Practice Location Address:

3663 ARCH RD STE 400
STOCKTON, CA
95215-8315

Practice Phone: 209-943-2202
Practice Fax: 209-943-2209

1720627656 — JARED VALENZUELA L.AC.
Practice Location Address:

3663 ARCH RD
STOCKTON, CA
95215-8315

Practice Phone: 209-943-2202
Practice Fax:

Directions to “ HOMER MCCOY HARRISON JR. PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.